Healthy Living

Doctors & Medicine

The Doctor Is In

The inside scoop on getting the most out of your next appointment

By The Editors of PreventionNovember 3, 2011

In an ideal world, your health care would be a partnership between you and your doc—where you're free to ask questions or even suggest your own therapy. But forming that partnership takes time, and time is a precious commodity in the era of managed care. Visits with doctors have always been shorter than they should be, and the rise of HMOs has made them even shorter, says Mary Jane Minkin, MD, clinical professor of obstetrics and gynecology at Yale University School of Medicine. "There's not a heck of a lot you can discuss with somebody in five minutes," says Minkin.

To make the most of your time with your doctor, you need to plan ahead and communicate effectively. (And avoid making this common doctor mistake.) Some of our experts and advisors shared the same strategies they use when they themselves are the patients.

Your Routine Checkup

This is your chance to discuss recent health problems as well as any physical or emotional changes that have occurred in the past year or six months. Routine checkups also give your doctor the opportunity to do comprehensive physical exams. To get the most out of the visit:

Know your family history. Many illnesses (and risk factors for illnesses) are influenced by a woman's family history. Before you arrive for your checkup, take a few minutes to mentally review the health of your parents, siblings, and children. You'll probably be asked to fill out a form and give details about your family's experience with heart disease, diabetes, and other conditions.

Bring medical records. Give your doctor a copy of any medical records that she doesn't already have. These might include reports of mammograms, Pap tests, colonoscopies, or other tests you've had within the past year. If you don't have copies of these reports, you can get them (usually free of charge) from the clinics or hospitals where they were performed. (Is it too early for a mammogram? Find out here.)

Make a list of current health concerns. It's easy to forget things when you're in the doctor's office. To make sure nothing gets missed, make a "cheat sheet" that lists symptoms or problems that are worrying you, such as a persistent cough, nagging joint pain, or difficulty sleeping, advises Marianne Legato, MD, director of Partnership for Women's Health at Columbia University in New York City.

Talk about tests. Ask your doctor if you're due for important screening tests, such as a cholesterol test or a mammogram.

Your Annual Pelvic Exam

No one looks forward to it, but the yearly pelvic exam is essential for a woman's long-term health. Here's how to make the most of this important appointment:

Think beyond reproductive health. Your gynecologist needs to know about allyour health issues, not only those that appear to involve the reproductive organs. Many common symptoms—fatigue, for example—may be linked to a woman's hormones. Your gynecologist can't provide comprehensive care unless she knows about any and all symptoms that may be troubling you, says Legato.

Don't hold back. It's not uncommon for women to make an appointment to see their gynecologist, then neglect to discuss personal or intimate details. Don't let embarrassment hold you back. If you're experiencing low sex drive, for example, tell your doctor. Are you having trouble controlling urine? Talk about it. The issues may be uncomfortable, but this is your chance to find out if something's wrong—and what you can do to resolve it, says Legato.

If you're uncomfortable, speak up. No one feels completely comfortable during a pelvic exam, but you shouldn't be in pain. Always let your doctor know if the exam is more uncomfortable than usual. She can probably reduce the discomfort—by using a smaller speculum, for example, or applying less pressure to the abdomen.

When You're Sick

Doctors aren't mind readers. Whether you're seeing your doctor because you have been fatigued, have a persistent discharge, or simply aren't feeling well, she won't know where to begin unless you describe your symptoms clearly.

"In at least 80% of cases, we can diagnose the illness before any laboratory testing—if the patient communicates effectively," Legato says. To communicate clearly:

Describe your symptoms exactly. If you have pain in a joint in your elbow, don't tell your doctor that you're feeling achy. If you have a cough, tell your doctor if it's "wet" or "dry"—or if it's painful or merely irritating. The more specific you are in describing symptoms, the easier it will be for your doctor to figure out what's going on, says Legato.

One woman told Legato that she felt as though blood couldn't get through her right calf. "That happens to be a perfect description of deep-vein thrombosis, which is exactly what she had," Legato says.

Leave the diagnosis to your doctor. Patients often walk into their doctors' offices and tell them what they think is causing their symptoms. Apart from the fact that a self-diagnosis is unlikely to be accurate, it can waste valuable time by leading your doctor in the wrong direction. You're better off simply telling your doctor your symptoms, says Helen K. Edelberg, MD, assistant professor in the Brookdale department of geriatrics and adult development at Mount Sinai School of Medicine in New York City.

Give all the details. Your doctor will want to know how long you've had symptoms, what you were doing when the symptoms began, whether you're having other symptoms at the same time, and if anything you do—such as lying down—makes the symptoms go away. The more information you provide, the easier it will be for your doctor to make an accurate diagnosis.

Discuss medications. Both prescription and over-the-counter medications could contribute to your symptoms or affect the treatment your doctor recommends. Before you leave home, make a list of medications you're taking. Remember to write down supplements or herbal treatments as well.

Don't leave without a diagnosis. We often assume that our doctors can figure out everything, but sometimes symptoms don't lend themselves to easy answers. And in some cases doctors simply neglect to explain things clearly. If you're not sure what the diagnosis is, ask your doctor to repeat it.

Make sure you also fully understand what your doctor says about test results, future plans, and treatment options. You won't be able to take proper care of yourself if you don't clearly understand what's happening with your health, says Barbara Korsch, MD, head of general pediatrics at Children's Hospital of Los Angeles and author of The Intelligent Patient's Guide to the Doctor-Patient Relationship.

Make sure you understand your instructions. Before leaving your doctor's office, take a moment to repeat everything you were told to do: what medicines to take, the proper dosage, and so on. Doctors often advise men and women alike to bring a notepad so they can jot things down while the information is still fresh. (In some cases, it's dangerous to drug and drive. Stay safe with these solutions.)

Discussing Treatment Options

More than two-thirds of all doctors' visits end with a prescription's being written, making medication the most common form of intervention.

Whether your doctor is recommending medications, physical therapy, or surgery, you have to be sure that you fully understand the implications of the treatment. Here are some questions everyone should ask:

What are the benefits? People often undergo treatments without really understanding what they stand to gain. Once you know why your doctor has recommended a particular course of action—taking a pill to "thin" the blood, for example, or using physical therapy to relieve pressure on a spinal nerve—you'll be more likely to stick with the plan. It's also important to discuss with your doctor the alternatives to treatment, including the anticipated results if treatment is not initiated. Sometimes people do get well on their own, says Korsch.

What are the side effects? Doctors are often reluctant to mention a medication's side effects because some people will report anything from itchy teeth to stools that glow in the dark, jokes Minkin. But you need to know if the medications you'll be taking are likely to cause problems—and you'll be more likely to keep taking them when you're sure that side effects are rare or insignificant, says Legato. "My greatest disappointment is when a patient says, 'I didn't fill the prescription because I was afraid of the side effects,' " Legato adds. "That means I didn't give the patient enough time to express concerns."

How soon will it work? Treatments don't always work right away, and it's important to know what to expect. An antibiotic will relieve symptoms within a day or two, while some antidepressants won't be fully effective for weeks. Physical therapy for back problems may take months. Knowing the time frame ahead of time makes it easier to gauge the effectiveness of treatment, says Minkin.

Get the Most from Tests

Diagnostic tests are essential for your health. Consider colonoscopy: If everyone—men and women alike—had this test at age 50 and regularly thereafter, there would be 25,000 fewer deaths annually from colon cancer.

No one likes getting mammograms, endometrial biopsies, or other tests. They're uncomfortable and inconvenient. They're also scary because you don't know in advance what the results will be. Don't let that hold you back. When your doctor orders tests, here are a few ways to calm your nerves and get all the information that you need:

Learn the details. Tests are scariest when you don't know in advance what to expect. Ask your doctor to describe the test in detail. Will there be pain? How long will the discomfort last? How long does it take to get results? The more information you get, the less nervous you are likely to be. Also, don't hesitate to ask other women, including women in the doctor's office, about their experiences with the tests—and what they did to relax and reduce the discomfort.

Know what's normal. When your doctor gives you the results of a test, ask for the normal range. For example, if you're premenopausal and you score a 55 on a follicle-stimulating hormone (FSH) test, your doctor should tell you that you're 25 points above the normal premenopausal score of 30. She'll also explain what this means, and how the numbers affect your long-term health.

Discuss a plan of action. If your test results are normal, your doctor might tell you to keep doing what you're doing. But if they're not, make sure you fully understand what you need to do in the months and years ahead.

How to Ask for Psychological Help

In one study, researchers analyzed the reasons for 537 doctors' visits. They found that 67% were at least partly about psychological concerns. Once again, however, your doctor can't know how you're feeling unless you bring it up.

Explain any emotional or psychological changes you have experienced lately. If you're having trouble remembering things, give your doctor specific examples—maybe you've been forgetting where you put things, or you can't remember parts of town that used to be familiar. Tell your doctor if you're crying more than you used to—and how often it happens. If you're having anxiety attacks, describe how they make you feel. Maybe your palms sweat or your heart races. These and other details will provide important clues about the underlying causes of your feelings.

Don't neglect to discuss physical symptoms, even those that appear to be vague or minor. Physical discomfort is a common sign of psychological difficulties, even in people who aren't aware that they're depressed or anxious, says Edelberg. Many women assume that their gynecologists or family doctors are concerned about solely their physical health. But your doctor is also trained to recognize psychological difficulties.